An epidemic survey on freshwater puffer poisoning in Bangladesh.

An epidemic investigation was carried out on freshwater puffer poisoning incidents in Bangladesh from April 1988 to May 1996. A lot of information on 10 poisoning cases involving 55 victims was collected through newspapers, interviewing the victims and their families, concerned hospital sources or questionnaires to them. Symptoms of the victims were partly similar to those caused by paralytic shellfish poison (PSP) or tetrodotoxin (TTX). Among them, however, muscle pain, discharge of black urine, and longer recovery time are clearly different. Further, serum creatine phosphokinase (CPK) values were found to be higher (230-450 and 298-430 IU/l) than normal values in two cases. From these different symptoms and high CPK values, it can be predicted/assumed that present freshwater puffer toxin is implicated in not only PSP, but also other toxin(s).